Tudor Cottage

Updated 25 March 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by three inspectors.

Service and service type

Tudor Cottage is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. A registered manager means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection.

During the inspection

We spoke with eight people who used the service and three visitors about their experience of the care provided. We spoke with two visiting health and social care professionals, eight members of staff including the registered manager, senior care staff, care staff and ancillary staff. We also spoke with the provider on both days of the inspection.

We reviewed a range of records. This included three people’s care records and medication records. We looked at one staff file in relation to recruitment and staff supervision. A variety of records relating to the management of the service were viewed. These included complaints and compliments, maintenance records, quality monitoring audits and minutes of meetings.

Updated 25 March 2020

About the service

Tudor Cottage is registered to provide accommodation and nursing and personal care for up to 19 people. The service is intended for older people, who may also have a physical disability, mental health needs or a dementia type illness. The service is in a large period house located in the market town of Axminster in East Devon. The home is within walking distance of Axminster town centre, local church and post office.

This inspection took place on 7 and 13 February 2020, the first day was unannounced. There were 16 people living at the service at the time of the inspection. One of these people were staying at the home for a period of respite care.

People’s experience of using this service and what we found

People were cared for by staff who knew how to keep them safe and protect them from avoidable harm. Staff were kind and compassionate and respected people’s privacy and dignity. The atmosphere within the home was friendly and welcoming and staff were warm and considerate towards the people they cared for.

There were sufficient staff available to meet people's needs and people told us when they needed assistance, staff responded promptly. The provider was monitoring the staff level at night to ensure it met people’s needs.

People’s medicines were safely managed, and incidents and accidents were investigated, and actions were taken to prevent recurrence. The home was clean, and staff followed infection control and prevention procedures.

The service continued to be effective. People's needs were assessed before they came to the home. At the time of the inspection the service was changing to a new electronic care record system. This meant some information about people’s care was on the old paper system and other information was on the new system. On the first day of the inspection, we found some people’s risk assessments and care plans lacked detailed information to guide staff about some safety aspects. We highlighted this to the provider. By the second day of the inspection, these risk assessments and care plans had been updated and were well understood by staff. The provider had arranged additional help to complete updating all people’s care records in the new format.

Staff were well trained and knowledgeable about people's care and support needs. People were provided with a nutritious and varied diet and they were positive about the quality and choice of food offered.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. When people were unable to make decisions about their care and support, the principles of the Mental Capacity Act (2005) were followed.

Staff were responsive to people's individual needs and had an in-depth knowledge about each individual. Staff offered people choices on an ongoing basis.

People had access to a range of activities and entertainment that they enjoyed. People's views and concerns were listened to and action was taken to improve the service as a result.

The service continued to be well led and benefitted from clear and consistent leadership. The management team were praised by staff, for their supportive approach.

Systems were in place to monitor the quality of care provided and continuously improve the service.

Why we inspected

This comprehensive inspection was brought forward two months because of concerns raised with the Care Quality Commission (CQC) and the local authority safeguarding team about people’s care, staffing and care practice, medicines management, documentation and leadership at the home. We made the decision to inspect earlier than planned so we could examine those risks as part of the inspection.

We also participated in a multiagency meeting with the provider and local health and social care professionals to discuss the concerns raised. This included identifying and agreeing further actions needed to support people living at the home and staff caring for them.

The last rating for this service was Good (published 17 August 2017).

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk